Background The principle of human dignity is woven into the ethical principles of the midwifery profession, noted as both an obligation and a human right. Research Objectives The aim of this study is to explore the experiences of midwifery students regarding threats to women's dignity during childbirth. Research Design This is a qualitative study with explorative design. Participants and Research Context: The research was carried out in 2022 at Kermanshah University of Medical Sciences, involving 32 midwifery students in individual interviews (...) that lasted between 30 and 90 minutes. These participants aged 21 to 28 years, with an average age of 23.5 years, provided their perspectives on the matter. Results Four key themes described the threats to women’s dignity during childbirth: 1) professional incompetence, 2) abuse of power imbalance, 3) caring only for physical and not mental health, and 4) structural issues within the healthcare system. Professional incompetence was characterized by outdated practices and lack of adherence to evidence-based medicine. Abuse of power imbalance was demonstrated in instances where the authoritative position of healthcare providers was misused, thereby disrupting the respectful care that women are entitled to receive. The disproportionate emphasis on physical health over mental health was evidenced by the disregard for mothers' psychological well-being during childbirth. Lastly, systemic structural issues emerged as significant impediments, revealing the need for system-wide changes. Ethical considerations: This study was approved by the Ethics Committee of the Research Deputy at Kermanshah University. Participation was voluntary and the confidentiality were maintained. Conclusion The findings underscore the role that unprofessional behavior, ethical lapses in medical practices, and systemic challenges play in undermining maternal dignity during childbirth. These threats necessitate urgent attention and must be adequately addressed in policy development and program implementation to safeguard the dignity of mothers during childbirth. (shrink)

This article examines how migrant ‘illegality’ is experienced in the Swedish context. How do ‘illegal‘ migrants manage work, housing, healthcare, safety and a family life in the absence of access to formal provisions? What are their survival strategies? I use direct quotations from undocumented migrants themselves to build a multifaceted picture of migrant ‘illegality’. Following Willen's (2007) call for a ‘critical phenomenology of illegality’, I move beyond the socio-political situation of undocumented migrants to their embodied experiences of being ‘illegal’. I (...) conclude that undocumented migrants are not excluded but are excepted; they have not been thrown out, but neither are they considered participants. Undocumented migrants are included in society without being recognised as members. (shrink)

Respect for autonomy is a key concept in contemporary bioethics and in ethics at the end of life in particular. An individualistic interpretation of autonomy may not incorporate the aspects of consideration that patients may have for their wider construct of personhood, which includes their love and consideration for their families. This anonymous case describes the intricacies of a patient’s decision making at the end of life, the choices she made, and how her decisions changed as her situation evolved. The (...) tension this produced within the medical team is unpacked using a lens of compassionate care in the intensive care unit. (shrink)

Pascal’s Wager is one of the most important and challenging arguments for the existence of God and the rationality of religious believes. According to this argument, where the rational and theoretical arguments for the existence of God are not satisfying, still in practice and decision-making, living on the basis of belief in God and other religious doctrines like life after death, is the most prudential and rational option and the best bet; although these believes are not rationally and certainly provable; (...) Avoiding the probable loss of atheism, namely eternal and infinite damnation in afterlife – that is more important than certain utility and restricted and finite pleasure of life in this world, is the ground of rationality of this decision-making. The psychological use of this argument is very effective, but the justificatory use of it have many difficulties; This article is concerned with the most important criticisms of this argument in terms of plurality of religions, rationalism, evidentialism, ethics of belief, voluntarism and probabilities calculus. (shrink)

What is the responsibility of the physician when a capacitated patient assigns decision-making authority to a surrogate who does not act in the patient’s best interest?

In the case described here, an often recurring and unresolved scenario is presented where communication issues are underpinned by pre-existing perceptions of mistrust between the caregivers and the surrogate family members in the intensive care unit. Racial factors play into this mistrust, when a family feel that their loved one is “yet again” not being treated in the best way possible. The perspectives of all stakeholders are considered in the discussion and relevant literature is cited.

Should the regulation of production and distribution in a socialist society be based on the law of value? In this article we ask (1) Is this question not based on an ontological understanding of labour, on a rational and therefore conceptual understanding of abstract labour and, ultimately, a transhistorical understanding of value and the so-called ‘law of value’?; (2) is it not precisely this deception and power of the fetishism of commodities that, by eternalising value and the ‘law of value’, (...) limits the horizon and perspective of ‘realistic politics’ (Realpolitik)?; and (3) whether this question does not treat socialism as a political situation where the solution to its ‘economic’ problem is unrelated to its very identity? In order to answer these questions, we provide a novel understanding of Marx’s fundamental category of value, its substance, form and magnitude, with the help of the German expression Formgehalt, translated as form-content. (shrink)

This investigation is intended to explore the effect of the digital environment as well as perfectionism during the COVID-19 pandemic on anxiety and depression. The study used a mixed-methods design; a mixed research methodology was used regarding explanatory design by using a qualitative sub-sample from quantitative sample data. The researcher conducted the study on a sample of 980 students and non-students smartphone and internet users using both qualitative and quantitative approach. Three different questionnaires were used: The Multidimensional Perfectionism Scale, Beck (...) Depression, and Beck Anxiety Inventory. On the other hand, the researcher designed a self-reported interview for the qualitative part that included 5 major questions and 10 sub-questions. The gathered data were investigated using SPSS version 22 to analyze the collected data for this study, and simple descriptive statistics and coding were used. The results denote that the digital environment is significantly correlated with multidimensional perfectionism in a low positive manner for students. However, the correlation effects for non-students are significantly high as evidenced by a significant positive correlation. Another finding suggests that there is a positive significant association between perfectionism and being depressed and anxious. (shrink)

This paper will discuss why and how social network sites ought to be used in surrogate decision making (SDM), with focus on a context like Singapore in which substituted judgment is incorporated as part of best interest assessment for SDM, as guided by the Code of Practice for making decisions for those lacking mental capacity under the Mental Capacity Act (2008). Specifically, the paper will argue that the Code of Practice already supports an ethical obligation, as part of a patient-centred (...) care approach, to look for and appraise social network site (SNS) as a source of information for best interest decision making. As an important preliminary, the paper will draw on Berg’s arguments to support the use of SNS information as a resource for SDM. It will also supplement her account for how SNS information ought to be weighed against or considered alongside other evidence of patient preference or wishes, such as advance directives and anecdotal accounts by relatives. (shrink)

Brain death certification can be a clinically and ethically challenging affair. Healthcare workers are expected to refer patients for brain death certification to identify potential organ donors, but family members may be ill-prepared for this turn of events. Already distraught families may not appreciate delays in brain death certification, but such delays are common because of the need to manage the patient’s altered physiological state to allow testing. Opportunities for donation are sometimes lost because of the unnecessary delay. With focus (...) on an opt-out organ donation law, we discuss causes of delays in brain death certification, and the ethical issues faced by clinicians in using tests to certify patients. To resolve the issues, we argue for the use of supplementary confirmatory tests as part of a more protocol-driven approach to brain death certification to avoid delays. Such tests should be regarded as part of the donation process funded by the state. (shrink)

Ras proteins function as critical relay switches that regulate diverse signaling pathways between cell surface receptors and the nucleus. Over the past 2‐3 years researchers have identified many components of these pathways that mediate Ras activation and effector function. Among these proteins are several guanine nucleotide exchange factors (GEFs), which are responsible for directly interacting with and activating Ras in response to extracellular stimuli. Analogous GEFs regulate Ras‐related proteins that serve other diverse cellular functions. In particular, a growing family of (...) proteins (Dbl homology proteins) has recently been identified, which may function as GEFs for the Rho family of Ras‐related proteins. This review summarizes our current knowledge of the structure, biochemistry and biology of Ras and Rho family GEFs. Additionally, we describe mechanisms of GEF activation of Ras in signal transduction and address the potential that deregulated GEFs might contribute to malignant transformation through chronic Ras protein activation. (shrink)

Our world suffers. Some people suffer more than others. Since the first part of 2020, ours is justly described as a time of uncertainty, threat, and upheaval. In this article, we offer reflections threaded narratively, told from the specificity of our societal contexts in Iran, Canada, and Australia. What might we learn in the present and anticipated future from people living chronically within conditions of uncertainty and immobility and also those experiencing uncertainty and immobility for the first time? We argue (...) that reflexive comparative analysis bridging social and visual analysis, anchored in embodied conditions of such people, offers a way to learn from responses to COVID-19 while also being an exercise in ethical research practice. This reflection builds on and extends from our scholarly collaborations that have been ongoing since 2015. Our title recognizes this specific virus as stealthy. Importantly, our choice of words identifies resident Iranians—whose experiences were the original impetuses for this paper, and whose lives provide its empirical basis —as equally steely. (shrink)

In this paper, we define the notion of PC-lattice, as a generalization of finite positive implicative BCK-algebras with condition and bounded commutative BCK-algebras. We investiate some results for Pc-lattices being a new class of BCK-lattices. Specially, we prove that any Boolean lattice is a PC-lattice and we show that if X is a PC-lattice with condition S, then X is an involutory BCK-algebra if and only if X is a commutative BCK-algebra. Finally, we prove that any PC-lattice with condition is (...) a distributive BCK-algebra. (shrink)

As systems based on opaque Artificial Intelligence (AI) continue to flourish in diverse real-world applications, understanding these black box models has become paramount. In response, Explainable AI (XAI) has emerged as a field of research with practical and ethical benefits across various domains. This paper not only highlights the advancements in XAI and its application in real-world scenarios but also addresses the ongoing challenges within XAI, emphasizing the need for broader perspectives and collaborative efforts. We bring together experts from diverse (...) fields to identify open problems, striving to synchronize research agendas and accelerate XAI in practical applications. By fostering collaborative discussion and interdisciplinary cooperation, we aim to propel XAI forward, contributing to its continued success. Our goal is to put forward a comprehensive proposal for advancing XAI. To achieve this goal, we present a manifesto of 27 open problems categorized into nine categories. These challenges encapsulate the complexities and nuances of XAI and offer a road map for future research. For each problem, we provide promising research directions in the hope of harnessing the collective intelligence of interested stakeholders. (shrink)

Objective: We hypothesized that the reasons behind this tension are complex and can be understood better by applying social psychology theory.Design: A qualitative methodology was drawn on for data collection and thematic analysis, with focus group discussions adopted for interviews with patient families and ICU physicians. Additionally, we used a social psychology theory, the reasoned action approach (RAA) framework, to understand these tensions.Setting: Two 15-bedded ICUs of an academic university–affiliated teaching hospital in Singapore.Subjects: A total of 72 physicians and family (...) members of older ICU patients (>70 years old).Measurements and Main Results: The primary analysis revealed five areas of tension around prognostication in the ICU. These dealt with issues of divergent views, different role expectations, conflicting emotional responses, and issues of communication and trust. Further analysis helped to identify underlying factors leading to tensions and behaviors. Differences in prognostication and in expectation of outcomes between clinicians and family members were the main cause of tensions. When the RAA framework was applied, these tensions could be predicted early on and understood more clearly.Conclusions: Tensions revolve around losing control of the patient’s care, differences between hopeful expectations and clinical prognostication, perceived biases of physicians, and underlying mistrust between families and physicians. (shrink)

Apart from the stylistic and cognitive studies which have already been done separately on Miller’sThe Crucible, this paper provides a new insight into the play and its system of characterization by integrating these approaches. To this end, the paper draws on Jonathan Culpeper’s cognitive stylistic theory of top-down and bottom-up processes in literary text comprehension and characterization. Based on this holistic framework, the paper takes advantage of such stylistic tools as speech acts, the Cooperative Principle and politeness theory to examine (...) features of the language used by the characters Proctor and Danforth. In this regard, the article assimilates those linguistic elements with the embedded schemata within the play. Consequently, the study reveals that Proctor’s complex characterization does not coincide with the readers’ schema and thus they form their impression of his character based on piecemeal integration. On the other hand, Danforth’s character reinforces the readers’ schema about a representative of the church discourse and thus they comprehend his character on the basis of confirmatory categorization. The paper concludes that while Proctor and Danforth have a passive existence in the text or in people’s minds, it is only in the interaction between their language and the readers’ minds that they come into existence. (shrink)

The article aims to introduce the works of eminent Iranian Marxist theoretician, Kamal Khosravi, to Western readers. Over the past few decades, Khosravi has written extensively on Marx, Marxism, and Marxist methodology. Through translations and his own writings, he has worked tirelessly to introduce Iranian readers to the rich debates on Marxist methodology and value theory that have developed in the West since the 1960s. More recently, as the lead editor of the Iranian journal Critique, his writings are (...) having an influence on the ongoing social movements as they are being disseminated and discussed amongst activists and labour leaders. In this article, we situate his writings within the developments of Iranian and Western Marxism. (shrink)